CMS Formulary

Displaying 193111-193120 of 1611142 results.
ID: 193111
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044355
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193112
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193113
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044969
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 193114
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044967
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 193115
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 2044971
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 193116
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 104206
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193117
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 309888
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193118
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 309889
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193119
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 1550946
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 193120
Formulary ID: 00021082
Formulary Version: 14
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30